Creating Culture Change: A Study Of How Evidence Is Moved Into Practice For Implementation Of A Public Policy Initiative In Ontario
Year: 2014
Type: dissertation
Abstract: The Ontario government, in an effort to close the gap between what we know (scientific inquiry) and what we do (public policy and practice) has, since 2009, supported implementation of the enhanced 18-month well-baby visit (18-month EWBV), in primary care practices throughout the province. Informed by the evidence, the 18-month EWBV represents innovation, an opportunity to expand the current, universal, 18-month check-up to a provision of care that supports standardized assessment at 18 months of age for each child in Ontario.This thesis begins in the author's experience, as a Program Consultant (Nursing), whose work it is to coordinate the development and implementation of provincial child development programs. As seen through the case of the 18-month EWBV, the study and its research are about knowledge work. Defined as a process that sees the creation of new knowledge during the transfer of knowledge in the context of the application of knowledge to clinical decision-making (Quinlan, 2009), the study is one of empirical inquiry. Understood that knowledge alone is insufficient to change practice, the study takes seriously the social and organizational processes of work and relations, often coordinated by documents (text) that shape the everyday experience of health professionals as they "invite or reject innovation" (Kontos Poland, 2009) that the 18-month EWBV represents.Using insights from institutional ethnography (IE) (D. Smith, 1987, 1999, 2005, 2006) as its method of inquiry, the study used experience as data and documents (text) as data. In its discovery, the study offers interview and document (text) analysis and maps knowledge work as those processes of work and relationship for the cause and effect of people's activities, made visible for how things happen as they do, in real life settings, for action that is coordinated, linked in relationship through documents (text), language, ways of speaking, and discourse, to organize experience (Turner, 2003, 2008; Webster, 2009).In its conclusion, the study moves beyond appreciation of knowledge translation (KT) as a set of individual processes and moves towards a new way of looking to understand and learn of the forces and processes of work and relation that shape change in the local context.
Source: TSpace (University of Toronto)
Author: Elizabeth Nancy Novak
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2754266671